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GS*HS*IHCS1*IHCS1*250814*1908*1457998957*X*005010X279A1~
ST*270*000000086*005010X279A1~
BHT*0022*13*000000086*2508226*1908~
HL*1**20*1~
NM1*PR*2*INTEGRATED HOME CARE SVC*****PI*IHCS1~
HL*2*1*21*1~
NM1*1P*2*DEVOTION HOME HEALTH CARE, LLC*****XX*1457998957~
HL*3*2*22*0~
NM1*IL*1*DURKIT*BONNIE****MI*8QY9VV7GK46~
DMG*D8*19420625*F~
DTP*291*RD8*20250814-20251112~
EQ*42~
EQ*30~
SE*14*000000086~
GE*1*86~
IEA*1*000000086~